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Leveraging Business Acumen to
Help Clinicians Get IT!
Session 12, February 12, 2019
Becky Fox, MSN, RN-BC, Chief Nursing Informatics Officer
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Becky Guess Fox, MSN, RN-BC
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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Overview of the IV and PCA Pump Project
Our Organizational Procurement Process
Opportunities Identified to Build “Relationship Bridges”
Understanding Clinical Body of Knowledge
Recognizing Need for Knowledge and Clinical Involvement
Agenda
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Building the operational, clinical business case
Laying the Foundation
Painting the Whole Picture with Valid Data
“Powering Up” and Achieving Organization Consensus
Determining ROI
Strategic Messaging to Build Consensus and Support for the
Project
Value Proposition
Facilitating Organizational Understanding of Health IT Value
Identifying Barrier and Risks
Lessons Learned and Key Take Aways from Our Organization
Questions and Answers
Agenda (continued)
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Apply methods learned through project examples provided to collaboratively engage
clinicians in establishing channels for communication and education that strengthens
financial and business acumen
Identify activities that clinicians and informaticists can employ to ensure assigned
projects are designed to be measured according to the metrics and key outcomes
that the healthcare enterprise is looking to achieve
Develop channels to identify opportunities for volunteering or shadowing senior
executives beyond traditional manager/mentor engagements that
clinicians/informaticists may utilize to gain insights into how decision-making occurs
at executive levels using financial/business analysis
Learning Objectives
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IV/PCA Pump Project
Replacement of IV and PCA pumps across 60+
patient care locations:
12 acute care facilities
>25 ambulatory and infusion clinics
Other settings such as free standing emergency
departments, outpatient surgery, mobile hospital,
School of Nursing, simulation center
Replacement only
Total of more than 6,000+ components of equipment
IV and PCA pumps would be utilized by more than
8,500 nurses to administer more than 1M+ infusions
annually
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IV and PCA Pump Replacement
Historical Perspective
Replacement of IV and PCA pumps were considered
separate projects
Implementation was scheduled facility by facility,
implemented over multiple years
Full technology benefit may not be achieved until
completion of rollout
Due to competing priorities, replacement projects can
often be postponed
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Established an interdisciplinary Steering Committee to provide
guidance, oversight and recommendations
Assess current state (internal and vendor assessments)
Determine infusion management plan/roadmap to meet
current and future needs
Determine key functionality requirements
Evaluate ROI analysis; determine outcome metrics
Recommend vendor
Submit request for purchase and achieve approval
Implement & monitor metrics for success!
Our Organization’s Procurement Process
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Opportunities Identified to Build
“Relationship Bridges”
Business and IT
Understanding
Technical and
Infrastructure
Requirements
Implementation
Process
Capital Process
Clinical
Understanding
Clinical Workflow
Requirements
Patient Safety
Impact
Future Infusion
Roadmap
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Financial modeling and is not (typically) a component of training
Career progression emphasizes staff management and clinical
outcomes with limited business and IT systems training
Business knowledge is not necessarily a regulatory requirement
Need for greater understanding of interdependencies and
complexities of IT systems management
Understanding Clinical Body of
Knowledge
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In 2006, the TIGER Initiative, a nursing grassroots community
recognized the need for improved preparation of clinical staff
using informatics to improve patient care
In 2011, the TIGER Initiative published recommendations of
Informatics Competencies which included a focus on:
Basic Computer Competencies
Information Literacy
Information Management
ANA has recognized the importance of early involvement of
clinicians in technology projects (Weckman, Janzen, 2009).
“The best IT project is the one that is not an IT project” (Murphy,
2009).
Need for Additional Knowledge and
Clinical Involvement
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Building the operational,
clinical business case
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Laying the Foundation
Leverage prior successful business cases
Identify decision makers, key stakeholders and influencers
Connect with other healthcare systems
Understand industry direction
Leverage vendor(s) success stories
Considerations for outside influences, such as regulatory
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Painting the Whole
Picture with Valid Data
Clinical (Pharmacy, Nursing)
Financial (product waste, risk)
Safety (drug library utilization, pharmacy build,
number of alerts and/or lack thereof)
Outcomes (care events, teammate satisfaction)
Workflow efficiencies (time and motion, LEAN,
Agile processes)
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Established Steering Committee
Minimum inclusion of at least1 stakeholder from key areas
impacted by project
Included Nursing, Pharmacy, Information and Analytic
Services, Technology, Clinical Engineering, Materials
Management, Procurement
Leveraged additional supporters through key groups such as
Clinical Informatics Coordinators, Physicians IT Leaders,
Informatics Councils, Nursing Practice Councils and other key
projects (e.g. Critical Care Leaders, Quality Leaders)
“Powering Up” and Achieving
Organizational Consensus
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Supporting teammate knowledge of business, financial and
strategic acumen through mentoring, formal & informal education,
group learning experiences, case-study review
Create opportunities to share the stories of success
Create opportunities to share the thought process of prior
successful projects
Create shadow experiences for key stakeholders, decision
makers
Rounding
Observations and discussions in/outside of organization
Informal discussions
Create opportunities for influencers of key stakeholders
“Powering Up” and Achieving
Organizational Consensus
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Review historic, successful key metrics
Consider cost savings, time/efficiencies, safety, outcomes, risk,
and impact to the experience of the consumer, patient, clinician
and teammate
Understand ROI is different, for different stakeholders in the
organization
Consider how each decision maker will view ROI:
Will individual ROI be weighted?
How will the project be prioritized?
Contextualize the project into the greater system needs
Consider how metrics will be evaluated throughout the project or
post-implementation
Determining ROI
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Consider what information to present (formally and informally):
Fact based
Without emotional components
Focus on each stakeholders view of value proposition
Tie to system goals of the health system
Consider different methods of communication:
Types of learners
Written considerations
Pictures and infographics help communicate complex topics
Strategic Messaging to Build Consensus
and Support for the Project
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A value proposition is a promise of value to be delivered,
communicated, and acknowledged.
It is also a belief from the customer about how value will be
delivered, experienced and acquired.
A value proposition can apply to an entire organization, or parts
thereof, or customer accounts, or products or services.
-Wikipedia
Value Proposition Definition
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Clinicians - Improved drug library; improved workflow with one
system for both IV and PCA pumps; improved patient safety
Pharmacy Improved drug library management
IT Easier management of pump and drug library updates;
improved equipment management
Security HIPPA compliant, US based data management
Operations Improved patient safety
Procurement One vendor for IV and PCA pumps
Finance / Leadership Improved patient safety, decreased risk;
improved teammate experience; and decrease in cost of rental
equipment
Strategic Messaging and Value
Proposition Examples
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Laying the foundation
Painting the whole pictured with valid data
‘Powering up’ and achieving organizational consensus
Determining ROI
Strategic Messaging to Build Consensus and Support for the
Project Developing value propositions
…and….
Facilitating the Organizational
Understanding of Health IT Value
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Make the (specific) Ask
Ask for personal, department, organizational support
Ask for approval of the project
Ask for commitment to project success
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“I’ve never” experiences
Factual stories and examples are needed
Misinterpretation of messaging
Information not disseminated effectively
Identifying Barriers and Risks
“Obstacles do not block the path, they are the path.”
Anonymous
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Create environment that develops business, financial and
strategic acumen with clinical staff (and vice versa)
Create formal and informal shadowing & learning experiences
between clinical, business leaders and teammates for future
initiatives and projects
Create opportunities to 'share' the stories of success as well as
the business, financial and strategic acumen which contributed to
the success
Make the ask!
Lessons Learned and Key Take Aways
from Our Organization
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AONE Position Paper Nursing Informatics Executive Leader. (2011).
http://www.aone.org/resources/informatics-executive-leader.pdf
Definition of value proposition, (2019).
https://www.en.wikipedia.org/wiki/Value_proposition
HIMSS Informatics-competencies (2010).
https://www.himss.org/informatics-competencies
Murphy, J. (2009). “The Best IT Project Is Not an IT Project” JHIM N
Winter. 23 (1), 6-8.
TechnologyInformaticsGuidingEducationReform (TIGER), (2009).
www.himss.org/file/1308891/download?token=C12Qjpt6. Collaborating to
Integrate Evidence and Informatics into Nursing Practice and Education:
An Executive Summary.
Weckman, H., Janzen, S., (2009). "The Critical Nature of Early Nursing
Involvement for Introducing New Technologies" OJIN: The Online Journal
of Issues in Nursing, Vol. 14, No. 2, Manuscript 2.
References:
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Contact information:
Becky G. Fox, MSN, RN-BC
Chief Nursing Informatics Officer
Becky.fox@atriumhealth.org
Linkedin: Becky G. Fox
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Questions